title: Surgical treatment problems of hydrocephalus caused by spontaneus intraventricular hemorrhage in prematurely born children.
abstract: OBJECTIVE
  The aim of this study was to identify the most appropriate method of surgical treatment of hydrocephalus in preterm infants that is caused by spontaneous intraventricular hemorrhage (IVH) and to identify predictive factors of poor perioperative outcomes.
  
  
  METHODS
  We present a series of 60 patients with IVH and hydrocephalus, to whom a VP shunt or subcutaneous (Omaya) reservoir was placed, during the period from March 2006 to March 2011.
  
  
  RESULTS
  Predictors of poor outcome with VP shunt placement were: gestational age (t=2.323, p=0.024), head circumference at birth (t=2.072, p=0.043), birth weight (t=2.832, p=0.006), Apgar score at birth (t=5.026, p < 0.01), number of days on assisted ventilation (Z=6.203, p < 0.001), peripartal asphyxia (χ < sup > 2 < /sup > =17.376, p < 0.01), respiratory distress (χ < sup > 2 < /sup > =9.176 p=0.002). Predictors of poor outcome in getting Omaya reservoir are: low birth weight (t=2.560, p=0.016), low Apgar scores (t=3.059, p=0.005), an extended number of days on assisted ventilation (Z=4.404, p < 0.001), presence of peripartal asphyxia (χ2=9.977, p=0.002) and cardio-respiratory arrest (χ2=12.804, p < 0.001).
  
  
  CONCLUSIONS
  The outcome of hydrocephalus caused by IVH in premature born children is the worst in perinatology. Our results suggest that the main predictive factor is preoperative condition of the child and that the VP shunt and Omaya reservoir are complementary methods of surgical treatment.
authors.affiliation: University Pediatric Hospital, Department of Neurosurgery, Belgrade, Serbia.
authors.forename: Miljan
authors.initials: M
authors.lastname: Mihajlovic
authors.forename: Vojislav
authors.initials: V
authors.lastname: Bogosavljevic
authors.forename: Igor
authors.initials: I
authors.lastname: Nikolic
authors.forename: Milan
authors.initials: M
authors.lastname: Mrdak
authors.forename: Nikola
authors.initials: N
authors.lastname: Repac
authors.forename: Vuk
authors.initials: V
authors.lastname: Scepanovic
authors.forename: Branislav
authors.initials: B
authors.lastname: Nestorovic
authors.forename: Goran
authors.initials: G
authors.lastname: Tasic
mesh_terms: D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000150:complications; D001724:Birth Weight; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000601:surgery*; D002552:Cerebral Ventricles / Q000601:surgery*; D005260:Female; D005865:Gestational Age; D006257:Head / Q000033:anatomy & histology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000601:surgery*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008297:Male; D019635:Neurosurgical Procedures; D011379:Prognosis; D012121:Respiration, Artificial; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt